A concise instrument for screening cognitive impairment: validation in a geriatric population

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BACKGROUND: The Short Portable Mental Status Questionnaire (SPMSQ) is a brief instrument designed to evaluate cognitive impairment in older adults. This study evaluates the validity and reliability of the Turkish SPMSQ and determines optimal cut-off values. METHODS: Patients aged 65 years and older were enrolled consecutively. Following the translation and cultural adaptation procedure, the Turkish versions of the SPMSQ and Standardised Mini Mental State Examination (SMMSE) were administered to evaluate cognitive status. The SPMSQ's diagnostic accuracy was evaluated by calculating the area under ROC curve (AUC). RESULTS: A total of 197 patients were included, comprising 48 with dementia and 149 controls. In 67% of the study population, total education time was under five years. ROC analysis of the overall study population identified an optimal cut-off point of the SPMSQ for differentiating dementia at ≥ 4 errors, yielding a sensitivity of 83.3% and specificity of 90.6% (AUC: 0.949). The cut-off point was determined as ≥ 4 errors for patients with ≤ 5 years of education time (sensitivity: 87.2%, specificity: 84.9%, AUC: 0.933) and ≥ 3 errors for patients with > 5 years of education time (sensitivity: 100%, specificity: 98.2%, AUC: 0.997). The SPMSQ and SMMSE scores showed a significant positive correlation (r = 0.661, p < 0.001). The cut-off point for the SMMSE was ≤ 25, demonstrating 83.3% sensitivity and 97.3% specificity, with an AUC of 0.947. This was not statistically different from the SPMSQ AUC (p = 0.93). CONCLUSION: The SPMSQ is a reliable instrument for dementia screening in older adults and is not inferior to SMMSE. These findings suggest that the SPMSQ can be effectively utilized in primary care and geriatric clinics as a quick and reliable cognitive screening tool, especially in populations with varying education levels.